Nursing Commons^™

Emergency Department Workplace Violence Against Nurses, Adam Johnson

MSN Capstone Projects

Emergency room nurses are often thought of as the adrenaline junkies of the nursing world. Emergency nurses interact with a wide array of patients and visitors and are often the first clinician a patient may see upon arriving at an emergency department. With this wide array of patients and visitors, also comes a volatile environment with the increased risks of violence against nurses. This violence could include verbal, physical, and emotional violence from patients, visitors, and even fellow staff members. As violence increases, nursing longevity decreases and thus further increases the expense of nursing on a facility. Therefore, this has …

Sepsis Alert Benchmark Project, Leigh A. Normand

MSN Capstone Projects

Sepsis is steadily rising as one of the leading health concerns in our country due to the high risk of mortality and morbidity. Based on the data released by the Centers for Disease Control and Prevention (CDC), the state of Texas, in 2018, had over 4,000 mortalities due to sepsis. Texas was ranked fifth in the nation for the highest sepsis mortality rate (Stats of the States - Septicemia Mortality, 2020). Anyone can develop an infection which can lead to sepsis, severe sepsis, or septic shock. Those at highest risk are infants, immunocompromised, advanced age, and those with chronic conditions …

Managing Hypertension With Lifestyle Modifications, Ladonna D. Willis

MSN Capstone Projects

Cardiovascular disease has taken the lives of millions of Americans, specifically, African Americans who do not have access to health care, which leads to morbidity and increased mortality. This benchmark project proposes to provide cardiovascular educational packets to patients who are admitted to the hospital and have been diagnosed with hypertension.

Meaningful Recognition And The Effect On A Medical-Surgical Unit's Staff Satisfaction And Retention, Lindsey Greene

MSN Capstone Projects

The current state of the American healthcare system is riddled with challenges. Nurse administrators are faced with the formidable tasks of decreasing operating costs; improving the patient experience; delivering high-quality and safe patient care; and decreasing the mounting rates of nurse turnover. Nurse leaders must understand the complexities of their work environment, including the key drivers for nurse satisfaction and retention. In 2005, the American Association of Critical Nurses developed six standards for creating a healthy work environment. (American Association of Critical Care Nurses, 2016). An adult, medical-surgical unit at a South Texas hospital was faced with rising rates of …

Decreasing The Fall Rate On A Medical Surgical Unit With An Enhanced Fall Algorithm In The Electronic Medical Record, Natali Sokolovski

Master's Projects and Capstones

This paper summarizes the quality improvement falls prevention project on a Medical-Surgical unit with an Enhanced Fall Algorithm incorporated in the Electronic Medical Record conducted by two Clinical Nurse Leader students of the University of San Francisco.

This project addresses the patient falls events in a San Francisco-Bay Area Hospital on a Medical-Surgical unit. The aim is to decrease the rate of falls on a Medical-Surgical microsystem unit by 50% with an Enhanced Fall Algorithm incorporated into the Electronic Medical Record by June 2021. The patient population consists of general medical surgical patients where many of the patients have an …

Psychological Aspects Of Adolescent Diabetes, Dawn Ziegler

Master of Science in Nursing Final Projects

Abstract

Adolescence is a time of swift change physically, psychologically, and socially. A severe onset of diabetes and the life-long treatment required can cause significant changes for adolescents integrating this chronic illness into their identity. This study examined the current literature surrounding self-esteem in the newly diagnosed adolescent with diabetes, the quality of evidence, and the knowledge gaps addressing the social and personal challenges of advancing through life with this illness. A systematic search contained articles between 2010-2020. Key search terms included adolescents, diabetes type 1, behavioral approaches, emotional health interventions, self-esteem, self-worth, self-image, psychological, psychosocial, coping, stress, and resilience. …

Using The Model For Improvement To Address Invasive Hemodynamic Safety Concerns In Critical Care, Selena Truban

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

The use of invasive catheters to monitor hemodynamic readings is common in the critical care setting and requires the use of specialized equipment. Variation in equipment set-up impacts operational efficiency and creates the potential for improper patient treatment based on inaccurate readings. The methodology of setting up and maintaining hemodynamic pressure lines in the critical care units lacked structural and processional measures, creating the potential for patient harm. Multimodal strategies, guided by the Model for Improvement, were used to increase the use of evidence-based methods for setting up and maintaining invasive hemodynamic lines in the critical care units. A …

Heart Failure Transitions Of Care Benchmark Project, Tamera M. Brandon

MSN Capstone Projects

Heart failure (HF) is a major cause of death associated with extensive morbidity and impaired quality of life. The incidence and prevalence of HF has also increased dramatically in the past three decades (Whitaker-Brown et al., 2017). HF now affects approximately 5.7 million people in the United States and is the cause of more than 55,000 deaths annually (Whitaker-Brown et al., 2017). Consequently, readmission rates of HF patients are an area of great concern. The purpose of this benchmark project is to decrease HF readmission rates in adults who had a recent HF related hospitalization by providing comprehensive transitional care …

Nurse Practitioners In Healthcare Benchmark, Jun Cho

MSN Capstone Projects

With the shortage of physicians and rise of healthcare costs, it is imperative that healthcare start looking at the best alternative to take care of patients. With average life expectancy increasing and baby boomers entering Medicare, there will be more in need for providers. There are many uncertainties and questions concerning nurse practitioners practicing independently, compared to physicians, about overall care and patient satisfaction. There have been many evidence-based researches that shows nurse practitioners can provide just as efficient and safe care as compared to physicians.

Effects Of Patient Monitoring While On Hormonal Contraceptives: A Benchmark Project, Ashley Simo

MSN Capstone Projects

The advancements made by the hormonal contraceptive industry has been a major advancement in the topic of women's health. However, it has been speculated through various complaints and studies that this pro-woman drug came with its risks. Common complaints about depressive moods have begun to be noted and associated with these drugs. This evidenced based project analyzes the correlation between hormonal contraceptives and the development of depressive symptoms. To better prove this, the study examines the effects of implementing patient contraceptive monitoring into practice, and its benefits.

Benchmark Project On Interactive Education Class For Osteoporosis Patients, Adrienne N. Johns

MSN Capstone Projects

Research project focusing on providing patients that have been diagnosed with osteoporosis with an non-traditional interactive educational opportunity to better their health and improve quality of life.

Catheter Associated Urinary Tract Infection, Latrina Mae Martin

MSN Capstone Projects

Catheter associated urinary tract infections (CAUTI) are a common preventable occurrence in healthcare. With many conditions requiring catheterization for numerous reasons, catheter use is unavoidable in many circumstances. The benchmark project will address the steps of data analysis, protocol approval, staff education, implementation, and post implementation data analysis. The previous 12 months of data on CAUTI rate, CAUTI mortality rate, number of catheter days, current protocols in place for catheter insertion/discontinuation, and catheter selection will be carefully reviewed. The data analysis will be presented to Administration for review and approval of a new protocol to decrease CAUTI rate. Once approved, …

The Relationship Between Professional Nurse Certification And Nurse-Sensitive Patient Outcomes In The Acute Care Setting: An Integrative Literature Review, Julie Oss

Nursing Masters Papers

Healthcare organizations are charged with controlling rising costs, integrating services, and improving the quality of care. This Scholarly Inquiry Project has led to a closer look at the impact nurses have on patient care outcomes. Little research correlates specialty nurse certification with patient outcomes, even though certification is the hallmark of excellence in clinical nursing practice. Qualitative data validates that nurses who attain specialty certification report feeling more empowered, having additional innate worth, and more collaborative influence. Despite the robust subjective evidence, limited data exist to demonstrate the objective benefits of specialty certification on patient outcomes. The purpose of this …

High School Students As Citizen Scientists To Decrease Radon Exposure, Ellen J. Hahn, Craig Wilmhoff, Mary Kay Rayens, Nicholas B. Conley, Emily Morris, Angela Larck, Trista Allen, Susan M. Pinney

Nursing Faculty Publications

Residents in rural Kentucky (KY) and suburban Ohio (OH) expressed concerns about radon exposure and lung cancer. Although 85% of lung cancer cases are caused by tobacco smoke, radon exposure accounts for 10–15% of lung cancer cases. Academic and community members from the University of KY and the University of Cincinnati developed and pilot-tested a family-centered, youth-engaged home radon testing toolkit. The radon toolkit included radon information, and how to test, interpret, and report back findings. We educated youth as citizen scientists and their teachers in human subjects protection and home radon testing using the toolkit in the classroom. Youth …

Implementation Of A Palliative Care Program In Rural Minnesota, Barbara Lenarz

Nursing DNP Projects

Background: Rural areas have higher percentages of older adults with multiple chronic illnesses yet disparities exist with access to palliative care (PC) in rural areas. Palliative care can improve quality measures that positively impact care and health outcomes.

Objective: The evidence-based project’s (EBP) objective was to implement a community-based PC program in a rural primary care clinic in rural Minnesota, US and evaluate quality metrics to further support program sustainability.

Design: The project developed and implemented a community-based PC program in rural Minnesota. A tool kit was created for use for the site’s care providers and leaders.

Setting/Subjects: …

Eliminating Barriers To Chinese American Diabetic Patients: Implementation Of Diabetic Cantonese Group Visits, Sabrina Wong

Doctor of Nursing Practice (DNP) Projects

Problems: Asian Americans have higher incidence and prevalence of diabetes mellitus type 2 and less preventive care and higher complication rates than the rest of the American population.

Context: According to the National Healthcare Quality and Disparities Reports (2016), Asian Americans are more likely to be diagnosed with diabetes compared to non-Hispanic whites by over ten percent.

Interventions: A comprehensive group visit program was implemented in a clinic in Oakland, Chinatown catered towards Cantonese-speaking diabetic patients. The group visit included culturally and linguistically appropriate materials related to nutrition, exercise, and diabetes knowledge. Each cohort attended a ninety-minute group visit session …

Cpm Machine Protocol For Knee Replacements, Lacy White

MSN Capstone Projects

A benchmark project was conducted regarding the use of a CPM machine postoperatively to increase standardization of care for total knee replacement patients while also increasing the patient’s range of motion of the knee and decreasing the post-surgical pain. Over a six week period of time, each patient was given a CPM machine no later than 2 hours post op after the total knee replacement surgery and each patient was discharged after a one night stay in the hospital under observation instead of inpatient. When the patient were discharged they would be followed by a home health service who will …

Standardized Bedside Report During The Transfer Of Care, Lauryn Fanning-Goff

MSN Capstone Projects

Optimization of our communication processes can prevent multiple adverse/sentinel events that will also prevent the organization from potentially being held liable to cover those costs. The use of a standardized form of handoff is supported by literature as a way to ensure critical information is not omitted. Completing the report at bedside allows the patient and family to be involved in care, improve patient safety, and enhance patient satisfaction scores (Baldwin & Spears, 2019). Because of this, the PICOT question is: “In staff nurses on a pediatric surgical unit (P), how would a standardized bedside report during the transfer of …

In-Basket Teamwork: Divide The Work And Multiply The Success The Registered Nurse Role In Ambulatory Clinic Ehr In-Basket Management, James Smoot

Master's Projects and Capstones

Electronic Health Record (EHR) in-basket results (e.g., lab results, pathology reports, etc.) must be reviewed and acted upon in a timely manner by clinical staff in order to provide safe and effective care to ambulatory patients. Delays in reading results are significant contributors to medical errors. A large backlog of in-basket results that have never been appropriately filed is both a safety concern and a symptom of other clinical workflow issues. EHRs have shifted a greater proportion of administrative and triage roles onto providers, contributing to provider burnout. This paper synthesizes some of the best evidenced-based practices available for the …

Increased Discharge Compliance Through Mental Health Follow-Up, Robert H. Kirby

MSN Capstone Projects

Emergency departments are being strained to their breaking points as a result of the recent COVID pandemic. These departments are in need of programs that can help to reduce stress on not only limited budgets but also reduce the strain on their overwhelmed staff. One such strain on emergency departments and their limited resources is the readmittance of mental health patients as a result of non-compliance of the discharge instructions. The change project looks to address whether following up 10 days post discharge can increase discharge instruction compliance and ultimately reduce readmissions. The aim of the project is through the …

Impact Of Technological Communication Devices, Joshua George

MSN Capstone Projects

Nurses, family members, and other medical professionals have always found it difficult when communicating with patients who have impaired communication. Those who fall under the category of impaired communication include those who are mechanically ventilated and those who have a tracheostomy. Ineffective communication skills on both ends of the spectrum have led to negative patient outcomes. According to Aslani, Niknejad, Maghaddasi, & Akbari (2017), ineffective communication in patients with impaired communication have led to numerous physical and mental complications. Discovering an effective communication method to implement has been of great importance in the nursing field.

The current practice of communicating …

Diabetes Education In The Emergency Department: Decreasing Repeat Visits And Admissions, Keith Hatfield

MSN Capstone Projects

Parkland Memorial Hospital (PMH) has many patients with diabetes under its care (Parkland Health & Hospital System, 2019a). Lewis et al. (2015) found that most patients with diabetes seeking care in a large urban ED lacked the basic diabetes survival knowledge needed to stay healthy. Poor diabetes control leads to complications and illness, which leads to repeat ED visits and inpatient admissions. A further literature review supported providing patients with additional diabetes education to reduce admissions.

This project will train the ED Registered Nurses (RN) to provide additional diabetes education at discharge and provide the patient with educational materials to …

Impact Of Hourly Rounding On Fall Rates: A Benchmark Paper, Monica D. Smith

MSN Capstone Projects

Falls and fall-related injuries create a significant financial burden on patients and healthcare organizations, particularly in adult inpatient hospital units such as rehabilitation and medical-surgical units. Costs associated with additional hospital days, diagnostic testing, and potentially fall-related surgeries can average about $14,000 per fall (The Joint Commission, 2015). Moreover, falls can be devastating in older adults, impacting their overall quality of life. According to Abou et al., 20% of yearly individual costs associated with falls are among patients with Parkinson's disease (2020). This is a proposal to implement a pre-and post-implementation change project. This paper addresses the use of evidence-based …

Mindfulness-Based Intervention Program For Nurses, Monica Savage

MSN Capstone Projects

Currently, in most health care facilities across the country, they are experiencing a shortage of nurses. Nurses are taking on heavy loads of patients that are only getting sicker. Many nurses are experiencing symptoms of burnout such as depression and anxiety. Many are also contemplating leaving the bedside because they are unable to cope with the stress they are experiencing.

Although most organizations have employee assistance programs for support, they are not being utilized. Implementing a mindfulness-based program will give nurses the tools they need at a moment’s notice when they need it. Giving nurses the tool to properly take …

Home Blood Pressure Monitoring, Bethany N. Hughes

MSN Capstone Projects

Hypertension is prevalent worldwide and is responsible for nine million deaths annually. Despite its prevalence, a majority of patients go unmanaged or undiagnosed (Kitt et al., 2019). Health complications of hypertension can be life-altering and life-threatening; therefore, if changes are not made to improve community hypertension control rates, worsened population health and financial burden on health systems may persist. Would you believe that an effective tool exists and has been endorsed worldwide to combat hypertension, yet it is not used consistently in practice? Furthermore, can you imagine this specific tool is easy to operate, cheap, and recruits patient involvement in …

Utilizing Simulation To Enhance The Medical Emergency Response Team In Schools, Jennifer Gaskill

MSN Capstone Projects

Modern technology and health care advancements have significantly affected the patient populations encountered across numerous health care and public settings. One such setting is the school systems within the United States where students and staff with complex cardiovascular conditions, who were once restricted due to medical concerns and associated risks, are now actively learning and working among their peers. Though these conditions are typically managed well in this population, their risk of sudden cardiac arrest (SCA) remains, and schools must be equipped and prepared to respond to such emergencies. Many buildings have developed Medical Emergency Response Teams (MERTs) intended to …

Burnout And Fatigue: A Potential Downside Of The Critical Care Nursing Profession, Samantha L. Ford

MSN Capstone Projects

Studies show that burnout and fatigue increase healthcare cost and decreases organizational profit due to increased rates of employee turnover, decreased employee satisfaction, a decrease in the quality of care provided to patients, and the development of a toxic work environment. The three principal factors of job-related burnout and fatigue will be addressed within the context of this paper including emotional exhaustion, depersonalization, and personal accomplishment.

Critical care nurses suffer from feeling emotionally depleted to the point they feel as though they can no longer give anymore of themselves to the patients they care for, which is a result of …

Comparison Of Education Styles For Nursing Students: Team-Based Learning Versus Traditional Lecture, Hannah Gean

MSN Capstone Projects

Nursing graduates are coming into the workforce still lacking in important areas. Nurses need to have cultivated leadership, communication, and satisfaction skills before they start their first job. For this to occur, nursing students need to be prepared with these qualities while they are still in school. It is important for students to not only learn healthcare knowledge but to have practical skills in a variety of areas. When students learn through the traditional lecture method, it is not always possible to assess and support their learning in leadership, communication, and satisfaction. To ensure that students are receiving these values …

Opioid Education Program, Cynthia De Atley

MSN Capstone Projects

Pain management has become a challenging field both for the patients, their families, and providers. The rise of the opioid crisis has made the availability of opioids limited, even for those patients who truly need the life changing medications. Nurses, physicians, and administrators play a vital role in patient education and the education regarding the importance of using opioids safely. Lack of patient education regarding the use, misuse, and side effects of opioids can lead to potential injuries, overdose, and even death.

Providing patients with an educational program would greatly decrease their risk of misuse and abuse of opioids. During …

Pain And Sedation Scales In The Pediatric Intensive Care Unit, Marsha K. Triana

MSN Capstone Projects

In the pediatric Intensive Care Unit (PICU) there is a need for analgesia and sedation to reduce pain and discomfort, allow for interventions, optimize ventilation, decrease the amount of time in the PICU, and improve outcomes including the time after discharge. Adequate management of sedation and pain is the key to healing, duration of hospitalization, as well as a decrease in mortality rates. It is essential to have adequate pain control to maintain healing and stress reduction. Over sedation with mechanically ventilated children in the PICU can have significant complications. Complications include withdrawal, risk for infection and increased the amount …